Clinical significance of residual tumors at repeat transurethral resection in patients with T1 bladder cancer

Abstract

To investigate the predictors of residual tumors at repeat transurethral resection of bladder tumors (re-TURBT) for the patients with T1 bladder cancer and evaluate the effect of the residual tumors on the prognosis of the disease. We reviewed the clinical data of the patients with T1 bladder cancer who underwent re-TURBT from 2008 to 2015 in our department. Seventy-two patients received re-TURBT 2-6 weeks after the initial TURBT. A total of 65 patients were followed up, and we recorded the events of tumor recurrence, tumor progression, radical cystectomy and cancer specific death.The influencing factors of re-TURBT positive rate were analyzed.The effects of re-TURBT positive or negative findings on the prognosiswere compared. 33.3% of the patients who received re-TURBT had residual tumours. Re-TURBT positive in T1 bladder cancer has significant correlation with tumor size (P<0.05). Residual tumors tended to be detected in patients with larger tumors (diameter ≥ 4 cm) but might have no relationship with tumor grade or tumor number. The recurrence rate within 3 month ofthe patients with residual tumours at re-TURBT was 25% (5/20), while there were no patients suffering recurrence who had no residual tumours at re-TURBT, which had a significant difference (P<0.001). However, the overall recurrence rate, progression rate, rate of radical cystectomy and cancer specific mortality showed no significant difference between the two groups (45% vs 40%, P=0.71; 10% vs 6.7%, P=0.64; 5% vs 8.9%, P=0.59; 5% vs 2.2%, P=0.55). For the patients with T1 bladder cancer, larger tumors could be a predictor for residual tumors at re-TURBT. The presence of residual tumors is associated with early recurrence.